Influenza Pediatric Care Plan

By Chelsea Johnson, MD, FAAP
Medically reviewed
December 16, 2020

What is Influenza?

Influenza, commonly called ‘the flu’, is a contagious disease caused by a group of respiratory viruses called influenza viruses.  Flu viruses usually cause the most illness during the colder months of the year. 

Sometimes the flu is confused with a cold, but flu symptoms come on suddenly and can be more severe. Symptoms can also overlap with those of COVID-19, the respiratory illness caused by the novel coronavirus. 

If you have the flu, you can spread the virus a day before your symptoms develop and up to seven days after you become sick. People with the flu are most contagious during the first 3 to 4 days of their illness.

Risk Factors for Influenza

Flu viruses are constantly changing, so if you’ve had influenza in the past, you may come down with it again. You are at greater risk of catching the flu and developing complications if you:

  • Are younger than 4 years
  • Are older than 65 years
  • Live in a nursing home or long-term care facility
  • Are pregnant or up to two weeks postpartum
  • Have a weakened immune system
  • Have a chronic illness
  • Have a body mass index of 40 or higher

Symptoms:

  • Sudden onset of fever
  • Chills
  • Sore throat
  • Nasal congestion
  • Headache
  • Cough
  • Decreased energy and weakness
  • Muscle aches and pains
  • Loss of appetite

How is the Flu Diagnosed?

Usually, your provider will make the diagnosis just by taking a history and doing a physical exam.

To know for certain, the most common test is the rapid influenza diagnostics test. Your doctor will swab the back of your child’s nose or throat and check the sample for antigens, substances that cause your immune system to produce antibodies. It takes less than a half hour to get results. 

How Long Does the Flu Last?

Fever and other symptoms usually end after about a week, but coughing and weakness may go on for longer.

How to Treat the Flu

If your child is generally healthy and experiences symptoms, you don’t need to see a doctor right away.  Simply treat your child’s symptoms with rest and over-the-counter medications, such as ibuprofen or acetaminophen.

Here is some care advice that should help.

Supportive Care

For a Blocked Nose

  • Use saline (salt water) nose drops or spray to loosen up the dried mucus. If you don’t have saline, you can use a few drops of bottled water or clean tap water.
  • Run a hot shower to create a steam-filled bathroom where your child can sit to help clear stuffiness
  • For children 8 years of age and older, saline sinus irrigation can provide better relief of congestion.

Fluids

  • Try to get your child to drink lots of fluids.
  • Goal: Keep your child well hydrated.
  • It will thin out the mucus discharge from the nose and loosen up any phlegm in the lungs.

Humidifier

  • If the air in your home is dry, use a humidifier. 
  • Reason: Dry air makes nasal mucus thicker.

Raw or irritated nose area from nose blowing or rubbing

Dab petroleum jelly on the skin under the nose to soothe rawness

Sore throat

  • Give hard candy or cough drops to relieve sore throat (only for kids older than 6)
  • Sip warm chicken broth. 
  • Some children prefer cold foods such as popsicles or ice cream.
  • Warm salt water gargles

Aches and pains 

  • Run a warm bath or use a heating pad to soothe aches and pains

Medications to treat influenza

If you promptly have your child evaluated by a doctor upon noticing symptoms, he or she may give you an antiviral such as oseltamivir (Tamiflu); zanamivir (Relenza); or baloxavir (Xofluza). Tamiflu comes in capsule form taken 5 days, Relenza is a powder you inhale, and Xofluza is a one-time dose of two tablets. If taken within 48 hours of the onset of symptoms, these can lessen symptoms and shorten the length of time you are sick by about a day. 

*Let your K for Parents doctor know if your child has risk factors for complications from the flu, or lives with anyone who has risk factors.

Medicines for Fever:

For children not drinking or playing due to fever, give acetaminophen (such as Tylenol) or ibuprofen (such as Motrin or Advil).  Follow packing instructions or check in with K for Parents for specific dosing recommendations for your child. 

Never give aspirin to children or teens, as such use has been linked to Reye syndrome, a rare but serious condition that can be fatal.

Treatment for Other Symptoms:

  • Pain: Use acetaminophen (such as Tylenol) or ibuprofen for muscle aches or headaches.
  • Cough: Can give honey 1 teaspoon (5 ml) for coughing spells as often as needed. Can also use cough drops. Do Not give to infants under 12 months of age due to risk of botulism.
  • Chicken soup: There’s no real proof that eating it can cure a cold, but sick people have been swearing by it for more than 800 years. Chicken soup contains a mucus-thinning amino acid called cysteine, and some research shows that chicken soup helps control congestion-causing white cells, called neutrophils.
  • Vapor rub: Recent studies show that children ages 2-11 years of age using vapor rub on chest and neck at bedtime provide symptomatic relief of nighttime cough, congestion and difficulty sleeping, allowing them and their parents to have a more restful night than those in the other study groups.

Prevention

You can reduce your risk of contracting influenza with some simple habits.

Experts widely agree that the single best way to protect against the flu is getting the flu vaccine. The vaccine is appropriate for anyone 6 months and older, and it’s important to get the flu shot each year.

It is now crucial to get the flu shot as COVID-19 continues to circulate.  The injection protects against the three or four flu viruses that research indicates will be most common that year. You can get the flu vaccine at your health care provider’s office or at many pharmacies.

And despite what you may have heard, the vaccine cannot give you the flu. Understandably, the vaccine can lead to flu-like symptoms when the body responds to the proteins in the vaccine. However, it is protective, and those symptoms are not as severe as the flu.

Good hygiene habits can prevent flu germs from spreading too: 

  • Regular hand washing with soap and water or hand sanitizer
  • Cough or sneeze into a tissue or your elbow.
  • If you are sick, stay home for at least 24 hours after any fever subsides.
  • Avoid touching your eyes, nose, and mouth to avoid germs entering your body.
  • Clean and disinfect surfaces and objects such as keyboards, doorknobs, and telephones that may be contaminated with germs.
  • Follow public health recommendations that are in place to prevent the spread of the novel coronavirus, which may include wearing a face mask in public and maintaining a six-foot distance from others.

Check in with K if…

  • You have questions to discuss with the doctor
  • You want to check in with the doctor for reassurance
  • You want to know your child’s dosage for over-the-counter medications

See a doctor in person if…

  • Your child becomes lethargic or extremely tired 
  • Your child develops Shortness of breath or is working hard to breathe
  • Your child is unable to keep food or liquids down
  • Your child complains of a severely painful sore throat that interferes with swallowing
  • Your child develops chest or stomach pain not relieved with Tylenol or ibuprofen
  • Your child develops severe muscle pain (most commonly the calves)
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.